Topical carbonic anhydrase inhibitor (IOP reduction) Pregnancy: SPC §4.6: there are no or limited data from use of ophthalmic brinzolamide in pregnant women; animal studies have shown reproductive toxicity following systemic administration. AZOPT is not recommended during pregnancy or in women of childbearing potential not using contraception. Breast-feeding: excretion in human milk unknown, a risk to newborns/infants cannot be excluded — decide whether to discontinue breast-feeding or AZOPT therapy.

Brinzolamide 1% Eye Drops (Azopt)

Brand names: Azopt

Brinzolamide 1% eye drops (Azopt) are a topical carbonic anhydrase inhibitor indicated to lower raised intraocular pressure in ocular hypertension and open-angle glaucoma.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One drop of AZOPT in the conjunctival sac of the affected eye(s)

Route: Topical ocular (AZOPT eye drops, suspension — brinzolamide 10 mg/ml)

Frequency: Twice daily; some patients may have a better response with one drop three times a day

Max: The dose should not exceed one drop in the affected eye(s) three times daily

SPC §4.2: dose applies when used as monotherapy or as adjunctive therapy. Elderly: no dose adjustment necessary. Shake the bottle well before use; if the tamper-evident snap collar is loose after removing the cap, remove it before use. Nasolacrimal occlusion or gently closing the eyelid after instillation is recommended to reduce systemic absorption. If more than one topical ophthalmic medicinal product is used, administer at least 5 minutes apart; eye ointments last. When substituting another ophthalmic antiglaucoma agent with AZOPT, discontinue the other agent and start AZOPT the following day. If a dose is missed, continue with the next dose as planned. Paediatric: safety and efficacy in infants, children and adolescents aged 0 to 17 years have not been established — AZOPT is not recommended for use in infants, children and adolescents; it has not been studied in pre-term infants (less than 36 weeks gestational age) or those less than 1 week of age (§4.4). Hepatic impairment: not studied, not recommended. No US (openFDA) record was fetched for this id.

Dose adjustments

Renal

SPC §4.2/§4.3: contraindicated in severe renal impairment. Not studied in patients with severe renal impairment (creatinine clearance <30 ml/min) or in hyperchloraemic acidosis; brinzolamide and its main metabolite are excreted predominantly by the kidney. Use with caution where there is a risk of renal impairment because of the possible risk of metabolic acidosis (§4.4).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Known hypersensitivity to sulphonamides
Severe renal impairment
Hyperchloraemic acidosis

Side effects

Dysgeusia — bitter or unusual taste (6.0%, most frequent treatment-related reaction)
Temporary blurred vision on instillation, lasting a few seconds to a few minutes (5.4%)
Eye irritation, eye pain, foreign body sensation in eyes, ocular hyperaemia (common)
Corneal erosion, keratitis, punctate keratitis, blepharitis, eye pruritus, dry eye, conjunctivitis (uncommon)
Dizziness, headache, paraesthesia, motor dysfunction, amnesia (uncommon)
Serious sulphonamide-type reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis (§4.4 — withdraw immediately if they occur)

Interactions

Oral carbonic anhydrase inhibitors — potential additive effect on the known systemic effects of carbonic anhydrase inhibition; concomitant administration with AZOPT has not been studied and is not recommended (SPC §4.4 'Concomitant therapy')
Other topical ophthalmic medicinal products — administer at least 5 minutes apart, eye ointments last (SPC §4.2)

Clinical monograph

How it works

Brinzolamide inhibits carbonic anhydrase isoenzyme II in the ciliary processes, suppressing aqueous humour secretion and reducing intraocular pressure.

Prescribing in practice

Contraindicated in sulfonamide hypersensitivity, as it is a sulfonamide and can rarely trigger systemic sulfonamide-type reactions.
Not recommended in severe renal impairment due to accumulation of the drug and its metabolite.
The suspension causes transient blurred vision; concurrent use with oral carbonic anhydrase inhibitors is not advised.

Monitoring

Monitor intraocular pressure and observe for ocular irritation, taste disturbance and any signs of systemic hypersensitivity.

Counselling the patient

Shake well before instilling and expect brief blurring afterwards.
Remove soft contact lenses before use and wait before reinserting them.
Press gently on the inner corner of the eye after instillation to reduce systemic absorption.

Evidence & guidelines

Per the SPC, brinzolamide is used either as monotherapy or as adjunct to beta-blockers or prostaglandin analogues for raised intraocular pressure.

Reference: Azopt SPC; EGS Glaucoma Guidelines 2020; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways